NURS 498 MIDTERM 2 QUESTIONS AND ANSWERS | NURS 498
STUDY GUIDE & PRACTICE TEST 2026/2027
- The client's blood urea nitrogen (BUN) level is 21.4 mmol/L.
- The BUN indicates impending renal failure and metformin should not be used in clients with renal or
hepatic impairment. - ANS ✔✔The nurse obtains the following information about a client before the
administration of metformin. Which of the following findings indicate a need to contact the health care
provider before giving the metformin?
- 0800 hours
- Oral corticosteroids should be taken in the morning to minimize adrenal suppression - ANS ✔✔The
nurse should teach a patient taking an oral corticosteroid to take the medication at what time?
- Increased urinary output
- Agents that block the effect of ADH on the renal tubules may be prescribed, allowing more dilution of
urine leading to increased urine output. - ANS ✔✔A client is being treated with a medication to block
the effect of the antidiuretic hormone to control the symptoms of the syndrome of inappropriate
antidiuretic hormone (SIADH). Which of the following findings indicates that the medication is effective?
- Do not stop taking the prednisone suddenly; it should be decreased gradually.
- Acute adrenal insufficiency may occur if exogenous corticosteroids are suddenly stopped. - ANS ✔✔A
client with systemic lupus erythematosus has a prescription for 2 weeks of high-dose prednisone
therapy. When teaching the client about prednisone, which of the following information is most
important for the nurse to include?
- Glyburide stimulates insulin production and release from the pancreas.
- The sulphonylureas stimulate the production and release of insulin from the pancreas. - ANS ✔✔Which
of the following information should the nurse include when teaching a client who has type 2 diabetes
about glyburide?
- Choose flat-soled leather shoes.
- The client is taught to avoid high heels and that leather shoes are preferred. - ANS ✔✔The nurse is
caring for a client with type 2 diabetes who has sensory neuropathy of the feet and legs and peripheral
arterial disease. Which of the following information will the nurse include in client teaching?
- Take calcium supplementation to normalize serum calcium levels.
- Oral calcium supplements are used to maintain the serum calcium in the normal range and prevent the
complications of hypocalcemia. - ANS ✔✔The nurse is caring for a client who had radical neck surgery
and develops hypoparathyroidism. Which of the following information should the nurse include in the
teaching plan?
- Administration of insulin
- Glucose levels increase when clients are taking corticosteroids, and insulin may be required to control
blood glucose. - ANS ✔✔A client with type 2 diabetes that is well-controlled with metformin develops an
, allergic rash to an antibiotic and the health care provider prescribes prednisone. Which of the following
information should the nurse anticipate while the client is taking the prednisone?
- Noon blood glucose of 2.9 mmol/L
- The nurse should assess the client with a blood glucose level of 2.9 mmol/L for symptoms of
hypoglycemia as the normal range is 4-6 mmol/L. - ANS ✔✔Which of the following laboratory values,
noted by the nurse when reviewing the chart of a hospitalized client with diabetes, indicates the need
for rapid assessment of the client?
c. Arrange for the patient to have blood drawn for a white blood cell count - ANS ✔✔A patient who has
been receiving antipsychotic medication for 6 weeks tells the nurse that the hallucinations are nearly
gone and that concentration has improved. When the patient reports flulike symptoms including a fever
and a very sore throat, what is the priority nursing action?
a. Suggest that the patient take something for her fever and get extra rest
b. Consider recommending a change of antipsychotic medication
c. Arrange for the patient to have blood drawn for a white blood cell count
d. Advise the physician that the patient should be admitted to the hospital
d. "It helps reduce my cravings." - ANS ✔✔The patient is preparing for discharge. The patient tells the
nurse, "Dr. Jacobson is putting me on some medication called naltrexone (ReVia). How will that help
me?" Which response indicates that medication teaching has been effective?
a. "It helps my mood so that I don't feel the need to do drugs."
b. "It keeps me from experiencing flashbacks."
c. "It is a sedative that will help me sleep at night."
d. "It helps reduce my cravings."
a. Relapses result from lack of good situational support. - ANS ✔✔Which of the following is the most
helpful message to transmit about relapse to the patient recovering from alcohol abuse?
a. Relapses result from a lack of good situational support.
b. Relapses are an indicator of treatment failure
c. Relapses are caused by physiological changes.
d. Relapses can be learning situations to prolong sobriety.
c. Demonstrate commitment to control the substance use - ANS ✔✔An appropriate initial outcome for a
patient recovering from substance abuse would be that the patient will do which of the following?
a. Discuss the addiction with significant others
b. Contemplate a life abstaining from the substance of abuse
c. Demonstrate commitment to control the substance use
d. Substitute a less addicting drug for the present drug
a. Readiness for change
d. Availability of support system - ANS ✔✔Which of the following factors is the most important for the
nurse to consider when planning interventions? (Select all that apply.)
a. Readiness for change
b. Risk of relapse
c. Financial ability
d. Availability of support system
STUDY GUIDE & PRACTICE TEST 2026/2027
- The client's blood urea nitrogen (BUN) level is 21.4 mmol/L.
- The BUN indicates impending renal failure and metformin should not be used in clients with renal or
hepatic impairment. - ANS ✔✔The nurse obtains the following information about a client before the
administration of metformin. Which of the following findings indicate a need to contact the health care
provider before giving the metformin?
- 0800 hours
- Oral corticosteroids should be taken in the morning to minimize adrenal suppression - ANS ✔✔The
nurse should teach a patient taking an oral corticosteroid to take the medication at what time?
- Increased urinary output
- Agents that block the effect of ADH on the renal tubules may be prescribed, allowing more dilution of
urine leading to increased urine output. - ANS ✔✔A client is being treated with a medication to block
the effect of the antidiuretic hormone to control the symptoms of the syndrome of inappropriate
antidiuretic hormone (SIADH). Which of the following findings indicates that the medication is effective?
- Do not stop taking the prednisone suddenly; it should be decreased gradually.
- Acute adrenal insufficiency may occur if exogenous corticosteroids are suddenly stopped. - ANS ✔✔A
client with systemic lupus erythematosus has a prescription for 2 weeks of high-dose prednisone
therapy. When teaching the client about prednisone, which of the following information is most
important for the nurse to include?
- Glyburide stimulates insulin production and release from the pancreas.
- The sulphonylureas stimulate the production and release of insulin from the pancreas. - ANS ✔✔Which
of the following information should the nurse include when teaching a client who has type 2 diabetes
about glyburide?
- Choose flat-soled leather shoes.
- The client is taught to avoid high heels and that leather shoes are preferred. - ANS ✔✔The nurse is
caring for a client with type 2 diabetes who has sensory neuropathy of the feet and legs and peripheral
arterial disease. Which of the following information will the nurse include in client teaching?
- Take calcium supplementation to normalize serum calcium levels.
- Oral calcium supplements are used to maintain the serum calcium in the normal range and prevent the
complications of hypocalcemia. - ANS ✔✔The nurse is caring for a client who had radical neck surgery
and develops hypoparathyroidism. Which of the following information should the nurse include in the
teaching plan?
- Administration of insulin
- Glucose levels increase when clients are taking corticosteroids, and insulin may be required to control
blood glucose. - ANS ✔✔A client with type 2 diabetes that is well-controlled with metformin develops an
, allergic rash to an antibiotic and the health care provider prescribes prednisone. Which of the following
information should the nurse anticipate while the client is taking the prednisone?
- Noon blood glucose of 2.9 mmol/L
- The nurse should assess the client with a blood glucose level of 2.9 mmol/L for symptoms of
hypoglycemia as the normal range is 4-6 mmol/L. - ANS ✔✔Which of the following laboratory values,
noted by the nurse when reviewing the chart of a hospitalized client with diabetes, indicates the need
for rapid assessment of the client?
c. Arrange for the patient to have blood drawn for a white blood cell count - ANS ✔✔A patient who has
been receiving antipsychotic medication for 6 weeks tells the nurse that the hallucinations are nearly
gone and that concentration has improved. When the patient reports flulike symptoms including a fever
and a very sore throat, what is the priority nursing action?
a. Suggest that the patient take something for her fever and get extra rest
b. Consider recommending a change of antipsychotic medication
c. Arrange for the patient to have blood drawn for a white blood cell count
d. Advise the physician that the patient should be admitted to the hospital
d. "It helps reduce my cravings." - ANS ✔✔The patient is preparing for discharge. The patient tells the
nurse, "Dr. Jacobson is putting me on some medication called naltrexone (ReVia). How will that help
me?" Which response indicates that medication teaching has been effective?
a. "It helps my mood so that I don't feel the need to do drugs."
b. "It keeps me from experiencing flashbacks."
c. "It is a sedative that will help me sleep at night."
d. "It helps reduce my cravings."
a. Relapses result from lack of good situational support. - ANS ✔✔Which of the following is the most
helpful message to transmit about relapse to the patient recovering from alcohol abuse?
a. Relapses result from a lack of good situational support.
b. Relapses are an indicator of treatment failure
c. Relapses are caused by physiological changes.
d. Relapses can be learning situations to prolong sobriety.
c. Demonstrate commitment to control the substance use - ANS ✔✔An appropriate initial outcome for a
patient recovering from substance abuse would be that the patient will do which of the following?
a. Discuss the addiction with significant others
b. Contemplate a life abstaining from the substance of abuse
c. Demonstrate commitment to control the substance use
d. Substitute a less addicting drug for the present drug
a. Readiness for change
d. Availability of support system - ANS ✔✔Which of the following factors is the most important for the
nurse to consider when planning interventions? (Select all that apply.)
a. Readiness for change
b. Risk of relapse
c. Financial ability
d. Availability of support system
